Histologic remission seen with infliximab treatment in ulcerative colitis

Last Updated: 2016-07-07

By Reuters Staff

NEW YORK (Reuters Health) - Infliximab can induce histological remission in ulcerative colitis (UC) patients, new findings show.

Histological healing is increasingly used as a therapeutic goal in UC treatment, and histological inflammation may better predict future relapse risk than endoscopic activity, note Dr. Fernando Jose Magro of the University of Porto in Portugal and colleagues. "Histological recovery in UC is often incomplete, and microscopic evidence of inflammation is common even in patients with quiescent colitis assessed clinically and by sigmoidoscopy," they add.

In the new study, online June 12 in the Journal of Crohn's and Colitis, Dr. Magro and his team looked at histological healing in 20 patients newly prescribed infliximab at baseline and after eight and 52 weeks on the drug. Histological remission was defined as a Geboes index of 3.0 or below, and mucosal healing as Mayo endoscopy subscore 0-1.

At baseline, 5% of patients were in histological remission, while 15% were by week eight and 35% after one year. At week eight, 40% of patients were in clinical remission and 45% had mucosal healing based on endoscopy. After one year on infliximab, 25% of patients were in clinical, endoscopic, and histological remission.

The investigators also looked at the correlation between the markers fecal calprotectin and lactoferrin and histological healing. The markers were most strongly correlated with healing at eight weeks, with an area under the curve (AUC) of 94% for calprotectin and 96% for lactoferrin, respectively. Both biomarkers had excellent positive predictive value for histological outcome at eight weeks (calprotectin 100%, lactoferrin 94%).

"The growing interest among clinicians for the use of histological remission as a treatment target in IBD is supported by our findings showing that infliximab is able to improve histological outcomes in UC patients," Dr. Magro and colleagues write. "Further research should be carried out with larger samples and control groups to clearly establish the impact of infliximab on histological outcome."

Dr. Magro did not respond to an interview request by press time.

Merck Sharp and Dohme Portugal funded the study. Dr. Magro reported relationships with Merck Sharp and Dohme and other companies.

SOURCE: http://bit.ly/29wUe61

J Crohns Colitis 2016.